Portal hypertension in alcohol-associated hepatitis: harmless and the reflection of systemic inflammation? - 21/08/25
, Lionel Moulis b, Joana Pissarra b, Benjamin Rivière c, Georges-Philippe Pageaux a, José Ursic-Bedoya a, dHighlights |
• | Severe portal hypertension does not predict 6-month survival in. |
• | Liver/spleen ratio is a key marker of severe portal hypertension in alcohol-associated hepatitis. |
• | Persistent portal hypertension is driven by systemic inflammation, not alcohol abstinence. |
• | Leukocyte count predicts the persistence of portal hypertension at 6 months. |
• | Dynamic inflammation reshapes portal hypertension progression in severe hepatitis. |
Abstract |
Background and Aims |
Portal hypertension is a prominent feature of alcohol-associated hepatitis. However, it is not established whether the severity of PH has a prognostic impact in AH. The aim of our study was to assess the impact of PH on 6-month transplantation-free survival (TFS).
Methods |
A monocentric retrospective analysis was conducted on patients with symptomatic AH, proven histologically, admitted in our tertiary care hospital from January 2013 to December 2021.
Results |
127 patients were included in the study, with a mean Discriminant Function and MELD score of 59.5 (±23.5) and 25.2 (±6.6), respectively. The only risk factor for severe PH at admission was the liver/spleen ratio. Patients were followed up for a median of 20 months. The median TFS was 16.8 months. Severe PH was not significantly associated with 6-month TFS, unlike the MELD score and nonresponse to corticosteroids. In addition, the leucocyte count was associated with persistent PH at 6 months.
Conclusions |
In our study, severe PH had no impact on 6-month TFS. Further investigations on the prognostic value of PH and its natural history in AH are warranted.
Le texte complet de cet article est disponible en PDF.Keywords : Alcohol-associated hepatitis, Portal hypertension, Spleen volume, Systemic inflammation
Abbreviations : AH, ACLF, PH, DF, VH, ALD, HVPG, TFS, GIB, PPG, BMI, BSA, GAHS, INR, CRP, mL, LVI
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Vol 49 - N° 8
Article 102668- septembre 2025 Retour au numéro
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